in fdg pet ct imaging of the chest · 72-year-old man, 23 mm spn in lul lepidic pattern...
TRANSCRIPT
04/10/2014
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María José García VellosoServicio de Medicina NuclearClínica Universidad de Navarra
Pitfalls in FDG PET‐CT Imagingof the Chest
Pärnu (Estonia)
Wednesday, October 8, 201410:40-11:20
• False negative– Tumors with low FDG metabolism:
• Mucinous lung adenocarcinoma• Lepidic pattern adenocarcinoma• Carcinoid Tumor
– Microscopic Disease
• False positive: inflammation/ infection– Tuberculsis, Granulomatosis, Sarcoidosis,
Aspergilosis, Histoplasmosis.– Pneumonía, Abscess– Pleurodesis– Reactive lymphadenopathy
FDG cellular metabolism
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Paravertebral Abscess and spondylodiscitis(Staphilococcus Aureus)
SUVmax=8,4
58 year-old man with mass in upper right lobe, destruction of T3-T4
Hamartoma73-year-old man, Colorectal Cancer. SPN LUL
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Pneumonia (Pneumocystis carinii and Staphilococcus aureus)
47-year-old woman, Breast Cancer. Neoadjuvant Therapy
Sarcoidosis
SUVmax=5
51-year-old woman with breast cancer. Neoadjuvant Therapy
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SUVmax=5
Tuberculosis
SUVmax=9SUVmax=12
40-year-old man with pulmonary mass and subcarinal lymphadenopathy
Pneumoconiosis62-year-old man, ex-smoker. Asbestos exposure. Respiratory Infection, Lymphadenopaty in thorax.
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Radiation-induced Pneumonitis39-year-old woman, Ovarian cancer recurrence.
Thoracothomy
Rib fracture
71-year-old man. Lung Adenocarcinoma, surgery (1 month)
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72-year-old man, 23 mm SPN in LUL
Lepidic pattern adenocarcinoma
SUV=0,95SUV=0,78
08/2013
SUV=0,98
03/2014
3 h. Dual-TimeΔSUV= 22%
1. Lung
2. Pleura
3. Lymph nodes
4. Thymic gland
5. Heart and vessels
6. Esophagus
7. Muscles
8. Bones and joints
9. Bone marrow
FDG PET-CT. Pitfalls
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Pleural Metastasis70-year-old man, Lung adenocarcinoma treated
Talc Pleurodesis66-year-old woman Lung Adenocarcinoma stage IV treated
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EmpyemaSUVmax=7,6 SUVmax=3,1SUVmax=11,8
68-year-old man, NSCLC LUL (14 cm) and lymphadenopathy
66-year-old man. CT: 2 cm SPN in RUL AdenocarcinomapT1 pN2 (4R)
SUVmax=3,3
cT1 N0
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Mononucleosis35-year-old woman, suspected lymphoma
SUVmax N1=3,4
SUVmax=6,4
SUVmax N2=3,6 EBUS FP
Squamous cell Ca.pT1a N0
71-year-old man.CT: 17 mm SPN in RUL
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Hyperplasia Thymus
Thymus NHL
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Atrial Fibrillation69-year-old-man, NSCLC, Chemo-Radiotherapy
64-year-old man, Bladder Ca. SPN in RUL
Esophagus
Esophagitis
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Esophagus
Gastroesophageal RefluxNeoplasia Esophagitis
Brown FatUSA Fat
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NHL refractary to Chemotherapy
Acute Fracture
51-year-old man, SPN in LLL.
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Paget Disease
Acute Fracture